In Reply: I agree with Drs Giugliano and Esposito that a healthy diet is very important and that this is the first thing that physicians should address with their patients. It is also the initial intervention recommended by the Adult Treatment Panel III update.1 However, diet generally produces only modest LDL-C reduction, varying between 7% and 14% in randomized trials.2,3 In contrast, in the IDEAL trial, intensive statin therapy reduced LDL-C in statin-naive patients by around 50%.4